HomeMy WebLinkAboutJoshi Right of Way ApprovalC1TY OF CARMEL RIGHT-OF-WAY PERMiT ���F ��� �� ��� �;
PERMii NUMBER: ��� ��/'/ �
Y'S DATE: � � " �S " I �
APPLtCANT {person doing the work)
COMPANY:
ADDRE55:
PHONE:
CUST�MER:
AQDRESS: �
PHONE:
ESTlMATED DATE OF WORK:
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ADDRESS OF PROIECT: �.c� ��� � ! � � �j ��-�; �� �� il,�
DESCRIPTION OF WORK (check al) that applyj
ROAD BORE � DRIVEWAY REPLACEMENT �
CONSTRUCT(ON ENTRANCE � LANE CLOSURE Q
STREET CUT � ROAD CL05URE ' �
OTNER (� - '` : '" "^� ^�
DESCRIPTION: �/� � ZI ),��YY,C ,� P� I�l1�r L. E p"GO L b'U ��� W�/�
TYPE OF SURFACE CUT (if applicable}: d/y J�J
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*NOTE: OPEN CUTS IN PAVEMENT REQUIRE BDARD OF PUBUC WORKS (BPWJ APPROVAL *
USE OF HEAVY EQUIPMENT YES � �►p �
DRAW{NG ATTACHED YES NO
*NOTE: ON REVERSE StDE flF THlS PERMtT, PROWIDE NAMES AND CONTACTS OF ALL SUB-CONTRACTORS t1VVOLVED
SURETY BOND. Piease see ltem #1 of the Right-of-Way Conditions. ,
BONDIN6 COMPANY:
BQNDING NUMBER:
EXPIRATION DATE:
As applicant for this
icant's
PERMIT GRANTED BY:
COMMENTS:
Gt/,
DATE iSSUED:
�
. REPAIR WORK INSPECTED AND APPROVED
t have inspected the repair ofthe above right-of-way and find it to be completely satisfactory.
=Way Permit, I understand and agree to aIl of the specifications ond
conditions listed on the ottached sheei.
C/�LL�':� 1����Y' ��''" ` /
(Print Name)
(City
��� �
(City Inspector) (Date Released}
�• Liberty
1Vlutual.
SURETY
` National Bond Center
350 E. 96th Street
Indianapolis, Indiana 46240
+1 (888) g442663 Fax: +1 (866) 5474883
CONTINUATION CERTIFICATE
To be attach8d to and form a part of surety bond number 32S591908
(the "Bond"), cross reference bond number
, for Right of W�
dated the 5th day of September, 2018 , in the penal sum of $�,000.00 issued b
Y
The Ohio Casualty Insurance Company as sure the "Sure
ty ( ty"), on behalf of
METATRON, LLC DBA CAPEHEART LANDSCAPE AND DESIGN as principal (the "Principal"), in favor of CITY OF CARMEL
ENGINEERING DEPARTMENT, as obligee (the "Obligee").
The Surery hereby certifies that this Bond is continued in full force and effect until the 5th day of
September, 2020 , subject to all covenants and conditions of said Bond.
Said Bond has been continued in force upon the express condition that the full e�ent of the Surety's liability under said
Bond, and this and ali continuations thereof, for any loss or series of losses occurring during the entire time the Surety
remains on said Bond, shall in no event, either individually or in the aggregate, exceed the penal sum of the Bond.
IN WITNESS WHEREOF, the Surety has set its hand and seal this
By:
22nd day of July, 2019
The Ohio Casualty Insurance Company
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(Surety) �JPGoaao�T'Qq2
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��-�M k fl�_� 0 1919 �
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— _ Timoih�r�Mikolajewski �y1 * �'�
Assistant Secretary - Liberty Mutual Surety —
The Smith Sawyer Smith Agency LLC
124 E 8th Street
Rochester, Indiana 46975-1508
LMIC - 3300
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